Li Yi-Lu, Hsu Yu-Ching, Lin Cheng-Yu, Wu Jiunn-Liang
Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Chinese Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan; Sleep Center, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
J Formos Med Assoc. 2022 May;121(5):995-1002. doi: 10.1016/j.jfma.2021.07.022. Epub 2021 Aug 6.
BACKGROUND/PURPOSE: Sleep disturbance and psychological distress are among the most prevalent comorbidities of tinnitus. We aimed to clarify the dose-response effects of these phenomena with tinnitus severity.
This study enrolled adult patients with subjective tinnitus for more than 6 months was conducted from January 2017 to December 2018 in one tertiary medical center and one local hospital. Data collected included demographic data and questionnaires, namely Tinnitus Handicap Inventory (THI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS).
In total, 1610 patients with tinnitus (1105 male, 68.6%) with mean age of 48.3 ± 14.3 years completed all questionnaires. The average THI score was 9.2 ± 19.4, and 82.4% of patients reported to have slight tinnitus (THI ranged 0-16). The mean PSQI score was 8.4 ± 4.3, and 70.8% of participants had sleep difficulty (PSQI > 5). Compared with patients with slight tinnitus, those with catastrophic tinnitus were mostly old women with lower body mass index, and had higher scores in ESS, PSQI, and HADS (all P < 0.05). In 1140 patients with sleep difficulty, independent factors influencing THI were age, ESS, and HADS, and positive correlations were observed between age-adjusted THI and ESS, HADS-A, and HADS-D (all P < 0.001).
Old age, daytime sleepiness, and psychological distress are highly associated with tinnitus severity among patients with sleep difficulty. Management of sleep disturbance and psychological distress is necessary to control tinnitus.
背景/目的：睡眠障碍和心理困扰是耳鸣最常见的共病。我们旨在阐明这些现象与耳鸣严重程度之间的剂量反应关系。
本研究于2017年1月至2018年12月在一家三级医疗中心和一家当地医院进行，纳入主观耳鸣超过6个月的成年患者。收集的数据包括人口统计学数据和问卷，即耳鸣致残量表（THI）、匹兹堡睡眠质量指数（PSQI）、爱泼沃斯思睡量表（ESS）和医院焦虑抑郁量表（HADS）。
共有1610例耳鸣患者（1105例男性，占68.6%）完成了所有问卷，平均年龄为48.3±14.3岁。THI平均得分为9.2±19.4，82.4%的患者报告有轻度耳鸣（THI范围为0 - 16）。PSQI平均得分为8.4±4.3，70.8%的参与者有睡眠困难（PSQI>5）。与轻度耳鸣患者相比，灾难性耳鸣患者多为老年女性，体重指数较低，ESS、PSQI和HADS得分较高（均P<0.05）。在1140例有睡眠困难的患者中，影响THI的独立因素为年龄、ESS和HADS，年龄校正后的THI与ESS、HADS - A和HADS - D之间存在正相关（均P<0.001）。
在有睡眠困难的患者中，老年、日间嗜睡和心理困扰与耳鸣严重程度高度相关。控制耳鸣需要对睡眠障碍和心理困扰进行管理。
